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November 12, 2019

As CMS continues to strengthen efforts to stop fraud and expand oversight, who you have in your network, on your staff, and who you contract with (vendors, delegates and entities) must come under much greater scrutiny.

Learn more about CMS-6058-FC and what it means to your organization. Understand where and how to gain insight into “affiliations” and how to be a step ahead of CMS. A roadmap of “Best in Class” processes to better protect you and prepare you in the event of an appeal will be shared in the webinar tomorrow, November 13th at 12:00 PM EST, by Verisys Corporation VP of Payer & Hospital Solutions, Jan Smith Reed.

CMS Final Rule: Medicare, Medicaid, and CHIP Program Integrity Enhancements to the Provider Enrollment Process effective Nov. 4, 2019

What does the CMS Final Rule do?

  • Enhances and expands CMS authority to deny or revoke provider enrollments
  • Greatly expands disclosure requirements on enrolling and revalidating providers and suppliers
  • Implements a new re-application bar
  • Expands the current re-enrollment bar

The Final Rule is Written with Goals of

  • Preventing providers or suppliers from circumventing program rules by coming back into the program under a different name
  • Identifying providers or suppliers from billing for services or items from noncompliant locations
  • Revoking providers or suppliers who exhibit a pattern or practice of abusive ordering or certifying of services or items covered under Medicare Parts A and B
  • Revoking providers or suppliers with outstanding debt to CMS

Jan Smith Reed is the presenter and has dedicated her career to discovering and implementing the best ways to take a holistic view as a best practice to protect the patient while cutting out the fraud, waste and abuse in health care.

She has a broad swath of expertise as a business-savvy executive with proven results in matrix management. She is well established in both commercial and government health plan management to include self-funded, fully insured, managed care, MAPD, PDP and Medicaid.

Ms. Reed is revered as an effective communicator and is tapped for national media interviews, marketing content, market perceptions, and strategies.

To sign up for Verisys’ Navigating the New CMS Rule (CMS 6058-FC) Webinar on November 13th at 12:00 PM EST click here.

Juliette Willard Written by Juliette Willard
Healthcare Communications Specialist
Being creative is my passion! Writer. Painter. Problem Solver. Optimist.
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